29 & 30 Dominion Road

Updated 25 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 9 August 2018 and was carried out by one adult social care inspector. We gave the service 48 hours’ notice of the inspection. This was because the service is small and we needed to be sure the manager and sufficient staff would be available.

Prior to the inspection the provider completed a Provider Information Return (PIR). This is a form which gives key information about the service, what the service does well and any improvements they plan to make. We also looked at the notifications we had received from the service. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. We reviewed other information to help inform us about the level of risk for this service. We considered this information to help us to make a judgement about the service.

People living at the service communicated using sign language. During the inspection staff assisted us to speak with two people who were living at the service. We also spoke with the registered manager and three members of staff. After the inspection we contacted two people’s relatives by telephone and five health and social care professionals by email.

We looked in detail at the care records and medicines administration records for everyone living at the service. We looked at four staff files, and a separate staff training matrix. We also looked at a range of records and documents including meeting minutes, policies, audits and environmental reports.

Updated 25 September 2018

We undertook an announced inspection at 29 & 30 Dominion Road on 9 August 2018. The last inspection of the service was carried out on 3 October 2016. At that time, we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Shortfalls related to people's rights being consistently upheld in line with the Mental Capacity Act

2005 and staff not consistently receiving regular training and supervision to enable them to carry out their duties.

The provider sent us an action plan in November 2016. This described what they were planning to do to comply with the regulations and improve in specific areas. At this inspection, we found that necessary improvements had been made.

Action on Hearing Loss at 29 & 30 Dominion Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Dominion Road can accommodate four people in two modified semi-detached houses. At the time of our inspection four people were living there. Dominion Road had four en-suite bedrooms upstairs, with communal living areas downstairs. This included a main open plan living and dining area, as well as a kitchen and garden. Office space and staff sleep-in facilities were also on the ground floor.

The service worked in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Systems and processes were in place to protect people from the risk of harm. Staff were trained in safeguarding, and they told us about what they would do if they saw or suspected any harm or poor care at the service.

Staff were trained in a range of relevant subjects, although some training records required reviewing and updating. Staff received regular supervision and appraisals, and the staff we spoke with were enthusiastic about their roles and the service.

We found that safe recruitment and selection procedures were in place and sufficient staff were in post to meet people’s needs. Staff were skilled and experienced in their roles and they knew people well.

People were involved in a range of activities, and were encouraged to try new things to improve their quality of life. Staff supported people to be as independent as possible in carrying out a range of activities.

A complaints policy was in place, and people, staff and relatives all felt able to make a complaint or raise concerns. Most people said that they would do this informally through the registered manager, but relatives and staff were aware that a formal process was in place if needed.

Policies, procedures and checks were in place to manage health and safety. This included the management of incidents and accidents.

The provider had processes in place to ensure that medicines were stored safely and people received their medicines correctly.

Staff helped people to access healthcare appointments when necessary. Health and social care professionals were involved in people’s care, plans and reviews.

Care records were clear and reflected people's needs and preferences, as well as risks associated with their needs or care. These were reviewed and updated regularly to ensure they continued to meet people’s needs.

Staff spoke positively about the management of the service. The management team carried out regular checks to monitor, review and improve the quality of the care and support people received.